Dr. Jin'S Premium Nose Clinic, Seocho gu, Gangnamdaero 621, Seoul, 06543, Korea.
Aesthetic Plast Surg. 2019 Oct;43(5):1295-1300. doi: 10.1007/s00266-019-01406-5. Epub 2019 May 28.
The authors initiated the use of a mastoid periosteum graft to augment or camouflage the dorsum and radix. This report describes the techniques and treatment outcomes of mastoid periosteum grafts in primary and revision rhinoplasty.
Medical records of 62 patients who underwent rhinoplasty with mastoid periosteum were reviewed retrospectively. Of these, 21 patients who participated in follow-up for more than 6 months were analyzed through a comparison of pre- and postoperative photographs. Aesthetic results were scored on a scale of 0 to 4 (0 = poor, 1 = fair, 2 = moderate, 3 = good, 4 = excellent) with photographic evaluation by two independent surgeons.
A mastoid periosteum graft was used in 32 primary and 30 revision cases. The graft was used to augment the radix (28 cases), dorsum (15 cases), and both radix and dorsum (19 cases). Cartilage underlay was combined with mastoid periosteum grafts in 38 patients (61.3%, 17 in radix graft, 8 in dorsal graft, and 13 in both). The aesthetic outcome score assessed in 21 patients was 2.8 on average (3.2 in primary and 2.4 in revision cases). Cartilage combined cases showed better aesthetic outcome than free graft cases (3.1 vs. 2.5, respectively). Three cases of partial graft resorption were found, but there were no major complications.
Mastoid periosteum grafting is a safe and effective method to augment the radix or dorsum in primary and revision rhinoplasty. Long-term partial resorption cannot be completely excluded, which necessitates further study.
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作者开始使用乳突骨膜移植物来增强或伪装鼻背和鼻根。本报告介绍了在初次和修复性鼻整形术中使用乳突骨膜移植物的技术和治疗效果。
回顾性分析了 62 例接受鼻整形术伴乳突骨膜的患者的病历。其中，21 例患者随访时间超过 6 个月，通过比较术前和术后照片进行分析。由两位独立的外科医生通过照片评估，将美学效果评分从 0 到 4 分（0=差，1=一般，2=中等，3=良好，4=优秀）。
在 32 例初次手术和 30 例修复手术中使用了乳突骨膜移植物。移植物用于增强鼻根（28 例）、鼻背（15 例）和鼻根和鼻背（19 例）。38 例患者（61.3%，17 例用于鼻根移植物，8 例用于鼻背移植物，13 例用于鼻根和鼻背移植物）采用软骨下置法联合乳突骨膜移植物。21 例患者的平均美学效果评分为 2.8 分（初次手术为 3.2 分，修复手术为 2.4 分）。软骨联合病例的美学效果优于游离移植物病例（分别为 3.1 分和 2.5 分）。发现 3 例部分移植物吸收，但无重大并发症。
乳突骨膜移植是一种在初次和修复性鼻整形术中增强鼻根或鼻背的安全有效方法。不能完全排除长期部分吸收的可能性，需要进一步研究。
证据等级 IV：本杂志要求作者为每篇文章分配一个证据等级。如需了解这些基于证据的医学评级的完整描述，请参考目录或在线作者指南 www.springer.com/00266 。
